What is ALIF?

ALIF stands for Anterior Lumbar Interbody Fusion, a type of spinal fusion surgery for the lower back.
This is one method of performing Lumbar Interbody Fusion, wherein the degenerated disc is removed from the front through the tummy and the space fused together with a bone graft/cage.

Why is it done?

The surgeon may suggest ALIF as a treatment choice depending on various factors such as the patient's spinal condition, age, activity levels, and medical history.

ALIF may be recommended for the following spinal conditions:

  • Degenerative disc disease (involving a damaged disc)
  • Spondylolisthesis (in which one vertebra slips over another)
  • Spinal stenosis
  • Failed back or revision surgery.
  • Scoliosis, Kyphosis
  • Spinal Tumours

What happens during the ALIF procedure?

Before the procedure, the patient will typically undergo a thorough evaluation by the surgeon to determine the underlying cause of their pain and whether an ALIF is an appropriate treatment option. This will also include an anaesthetic assessment for fitness for surgery.

The surgery is usually performed under general anaesthesia, and the patient lies face up (facing the ceiling) on the operating table.

The surgeon will make a small incision in the patient's abdomen, usually just above the pubic bone. The surgeon will move aside the patient's abdominal muscles and organs to gain access to the spine. The damaged disc in the lower spine using specialized instruments.
Bone graft placement. Bone graft into the space where the damaged disc was removed. This graft may be taken from the patient's body (such as the hip) or a synthetic or donor bone graft. Metal screws, plates, or cages help support and stabilize the spine while the bone graft heals. The incision is closed using sutures or staples.

What happens after the procedure?

After the procedure, the patient is taken to a recovery room, where they are monitored briefly before discharge. Patients can usually return home after safely mobilising following the surgery. Depending on the case's complexity, this may be a day or a few days.

Patients are given pain medications to manage the discomfort. They may also be instructed to avoid bending, lifting, or twisting for several weeks. Patients may need to undergo physical therapy to strengthen their muscles and improve their range of motion. The recovery period varies for each patient, but most patients are off work for initial four weeks. If it’s a strenuous job, then you may be off for up to 8 weeks.

What are the potential side effects of the procedure?

As with any form of surgery, there are risks associated with it.

Possible some list of complications include:

  • Infection
  • Nerve damage
  • Bleeding
  • Blood clots
  • Bowel or bladder problems
  • Retrograde ejaculation in men due to damage of nerves.

All the risks and benefits will be discussed during the consent process.

The primary risk of ALIF is bleeding, which can happen in 15 out of 100 cases from major vessels.

Please consult your physician for a complete list of indications, warnings, precautions, adverse effects, clinical results, and other important medical information that pertains to the ALIF procedure.

Several factors can negatively impact a solid fusion following surgery, including smoking, diabetes or chronic illness, obesity, malnutrition, osteoporosis, and long-term (chronic) steroid use.

Please follow the BASS (British Association of Spinal Surgeons) website for more information.

Learn about conditions addressed by ALIF:

Lumbar Disc Prolapse: Discover a common condition that ALIF can address, involving the slipping of a disc in the lower back.
: Learn about vertebral slippage in the spine that can be treated with ALIF.

Also, read about technological advancements in spine surgery:

Artificial Intelligence in spine surgery: Gain insight into how AI revolutionises spinal surgical procedures.